Evaluation of knowledge and practices of nurses with regard to prevention of nosocomial infection in the intensive care units of Eastern Cape Province
- Mlenzana, Nosiphiwo Priscilla
- Authors: Mlenzana, Nosiphiwo Priscilla
- Date: 2015
- Subjects: Nosocomial infections http://id.loc.gov/authorities/subjects/sh85092770 , Cross infection--Prevention http://id.loc.gov/authorities/subjects/sh2009122612 , Infection http://id.loc.gov/authorities/subjects/sh85066076
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19639 , vital:43154
- Description: Aim: To determine the level of knowledge and practice of the nurses in the prevention and control of nosocomial infection in the intensive care units and make recommendations aiming at bridging the gap identified. In this study, the level of knowledge and practice of nurses in the intensive care units was described and its relationship with the demographic characteristics was examined utilising a quantitative approach. A quantitative descriptive design was used to examine and describe knowledge and practices of intensive care nurses with regards to prevention and control of nosocomial infection. One hundred and thirty (130) nurses participated in the study taken from the intensive care units of the five (5) state hospitals of the Eastern Cape Province. A self-designed questionnaire with close-ended questions was utilised comprising of dichotomous questions, with ‘yes’ or ‘no’ measuring knowledge nurses have and a Likert scale that measured knowledge with regards to clinical practice utilised in the prevention and control of nosocomial infections. The following ethical considerations were addressed by the study: ethical clearance, permission to conduct the study, informed consent from participants, anonymity and confidentiality and respect of individual autonomy. Findings: The respondents showed encouraging agreement with the different practices that should be followed in order to prevent spreading of nosocomial infections in their units. This knowledge suggests that the problem of infection control in ICUs may be related to the individual characteristics of the profession as opposed to being institutional. Limitations: Not all the intensive care units of the Eastern Cape hospitals were included due to challenges of time, finance and geographic factors. Recommendations: The following recommendations were made: Orientation programme to all new staff coming into the ICUs including infection control policies and guidelines; Involvement of the ICU staff in the development of infection control policies so as to ensure ownership and ultimate compliance; The employer must ensure that all resources for infection control and prevention are available and accessible to the health care workers at all times to ensure compliance. , Thesis (MCur) -- University of Fort Hare, 2015
- Full Text:
- Date Issued: 2015
- Authors: Mlenzana, Nosiphiwo Priscilla
- Date: 2015
- Subjects: Nosocomial infections http://id.loc.gov/authorities/subjects/sh85092770 , Cross infection--Prevention http://id.loc.gov/authorities/subjects/sh2009122612 , Infection http://id.loc.gov/authorities/subjects/sh85066076
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19639 , vital:43154
- Description: Aim: To determine the level of knowledge and practice of the nurses in the prevention and control of nosocomial infection in the intensive care units and make recommendations aiming at bridging the gap identified. In this study, the level of knowledge and practice of nurses in the intensive care units was described and its relationship with the demographic characteristics was examined utilising a quantitative approach. A quantitative descriptive design was used to examine and describe knowledge and practices of intensive care nurses with regards to prevention and control of nosocomial infection. One hundred and thirty (130) nurses participated in the study taken from the intensive care units of the five (5) state hospitals of the Eastern Cape Province. A self-designed questionnaire with close-ended questions was utilised comprising of dichotomous questions, with ‘yes’ or ‘no’ measuring knowledge nurses have and a Likert scale that measured knowledge with regards to clinical practice utilised in the prevention and control of nosocomial infections. The following ethical considerations were addressed by the study: ethical clearance, permission to conduct the study, informed consent from participants, anonymity and confidentiality and respect of individual autonomy. Findings: The respondents showed encouraging agreement with the different practices that should be followed in order to prevent spreading of nosocomial infections in their units. This knowledge suggests that the problem of infection control in ICUs may be related to the individual characteristics of the profession as opposed to being institutional. Limitations: Not all the intensive care units of the Eastern Cape hospitals were included due to challenges of time, finance and geographic factors. Recommendations: The following recommendations were made: Orientation programme to all new staff coming into the ICUs including infection control policies and guidelines; Involvement of the ICU staff in the development of infection control policies so as to ensure ownership and ultimate compliance; The employer must ensure that all resources for infection control and prevention are available and accessible to the health care workers at all times to ensure compliance. , Thesis (MCur) -- University of Fort Hare, 2015
- Full Text:
- Date Issued: 2015
Surveillance study on pathogenic Acinetobacter species in freshwater environment of the Amathole and Chris Hani District Municipalities, Eastern Cape, South Africa
- Adewoyin, Mary Ayobami https://orcid.org/0000-0001-7489-7402
- Authors: Adewoyin, Mary Ayobami https://orcid.org/0000-0001-7489-7402
- Date: 2019-09
- Subjects: Acinetobacter infections http://id.loc.gov/authorities/subjects/sh95004928 , Acinetobacter http://id.loc.gov/authorities/subjects/sh91001451 , Nosocomial infections http://id.loc.gov/authorities/subjects/sh85092770
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/19836 , vital:43257
- Description: This study evaluates the occurrence of medically relevant Acinetobacter species in three rivers, namely; Keiskamma, Tyhume and Great Fish in the Eastern Cape Province, South Africa in one year sampling regime (April 2017 - March 2018). The physicochemical parameters (pH, temperature (TEM), electrical conductivity (EC), total dissolved solids (TDS), salinity (SAL), total suspended solids (TSS), turbidity (TBS), dissolved oxygen (DO) and biological oxygen demand (BOD)) of the water bodies were measured. The presumptive Acinetobacter species recovered from the freshwater resources were recorded and further confirmed using molecular techniques. Similarly, confirmed isolates were subjected to speciation using species-specific primer sets for A. baumannii and A. nosocomialis. Also, virulence genes namely; afa/draBC, epsA, fimH, OmpA, PAI, sfa/focDE, and traT in the two Acinetobacter species were also determined using molecular method. In addition, the antibiogram characteristics of A. baumannii and A. nosocomialis isolated from the water samples were determined using standard methods. The antibiotic susceptibility test was performed using a panel of 12 antibiotics belonging to the aminoglycosides (amikacin, AK and gentamicin, GM), β-lactam/β-lactamase-inhibitor combinations (piperacillin-tazobactam, PTZ), cephems (ceftazidime, CAZ, cefotaxime, CTX, and cefepime, CPM), carbapenems (imipenem, IMI and meropenem, MEM), fluoroquinolones (ciprofloxacin, CIP), folate pathway inhibitors (Trimethoprim/sulfamethoxazole, TS), lipopeptides (Polymyxin B, PB) and tetracyclines (tetracycline, TET). Similarly, antibiotic resistance genes (ARGs) present in the Acinetobacter isolates were investigated including aminoglycoside resistance genes (aacC2, aphA1 and aphA2), β-lactamases resistance genes (blaTEM, blaSHV, blaOXA-1-like, blaCTX-M(GROUP 1), blaCTX-M(GROUP 2), blaCTX-M(GROUP 9), blaVEB, blaGES, blaPER, blaCTX-M-8/-25, blaOXA-48-like, blaVIM, blaIMP and blaKPC), fluoroquinolones resistance genes (qnrA, qnrB, qnrC, qnrD and qnrS), sulfonamide resistance genes (sul1 and sul2), and tetracycline resistance genes (tetA, tetB, tetC, tetM, tetL and tetO). The pH, EC, TDS, SAL, TEMP, TSS, TBS, DO, and BOD for Tyhume River ranged as follows: 7.2-7.7, 125-141 μS/cm, 62-71mg/L, 0.06- 0.07 PSU, 11.3-20.2oC, 30.0-89.6 mg/L, 35.0-96.0 NTU, 8.2-9.8 mg/L, 2.0-4.2 mg/L, while for Great Fish River, the parameters were 8.0-8.2, 274-369 μS/cm, 137-184mg/L, 0.13-0.18PSU, 12.7-22.3oC, 44.3-99.4 mg/L, 48.0-214.0 NTU, 7.8-9.9 mg/L, 3.1- 4.9 mg/L, and at Keiskamma River they were 7.5-7.9, 153.2-285.0 μS/cm, 86-143 mg/L, 0.07-0.14 PSU, 11.0-21.4oC, 27.0- 55.6 mg/L, 31-61 NTU, 8.3-9.8 mg/L, 3.0-6.0 mg/L. A total of 1107 presumptive Acinetobacter spp. were recovered from the rivers sampled of which 428, 370 and 309 isolates were recovered from Tyhume, Great Fish and Keiskamma rivers respectively. However, only 844 was confirmed positive for the genus Acinetobacter and are recovered in the proportions 285 (77 percent), 219 (70.9 percent) and 340 (79 percent) from Great Fish, Keiskemma and Tyhume rivers respectively. Our finding revealed that 410 (48.58 percent) and 23 (2.7 percent) of the isolates were confirmed to be A. baumannii and A. nosocomalis respectively. Also, 308 (75.12 percent percent) A. baumannii and 3 (13.04 percent) A. nosocomialis isolates exhibited one or more virulence genes out of the seven tested, whereas 102 (24.88 percent) and 20 (86.95 percent) of the A. baumannii and A. nosocomialis isolates did not harbour any virulence gene. Additionally, OmpA was the most prevalent (p<0.05) virulence gene found in A. baumannii with 69 (45.10 percent), 52 (50.98 percent) and 77 (49.68 percent) isolates from Great Fish, Keiskamma and Tyhume rivers respectively. The rates of susceptibilities of A. baumannii and A. nosocomialis to the antibiotics followed the order; Piperacillin-tazobactam (72.8 percent ; 73.9 percent), Ceftazidime (70.5 percent ; 91.3 percent), Cefotaxime (16.8 percent ; 17.4 percent), Cefepime (88.5 percent ; 95.7 percent), Imipenem (95.9 percent ; 100 percent ), Meropenem (92.7 percent ; 91.3 percent), Amikacin (97.6 percent ; 91.3 percent), Gentamicin (89.8 percent ; 87 percent), Polymyxin B (84.4 percent ; 91.3 percent), Tetracycline (74.7 percent ; 78.3 percent), Ciprofloxacin (75.9 percent ; 78.3 percent) and Trimethoprim/sulfamethoxazole (74.0 percent ; 73.9 percent) respectively. Both A. baumannii and A. nosocomialis were highly susceptible to all the antimicrobials tested except cefotaxime where 64 percent and 78 percent intermediate responses were observed in the species. At least 10 isolates of A. baumannii were resistant against each of the antibiotics used. The modal multiple antibiotics resistance phenotypes (MARPs) for Acinetobacter spp. was MARP 3 (29.87 percent) and the least was MARP 10 and 11 (2.6 percent each). The antimicrobial resistance index (ARI) was higher at two sampling sites KE2 (0.33) and TY1 (0.22). Similarly, MARI showed that sampling sites KE2 was a hotspot for multidrug-resistant Acinetobacter spp. Of the five classes of ARGs studied, there was a widespread of β-lactamases (blaTEM) in the two Acinetobacter species, followed by sul2, which were detected in 67 (63.2 percent) and 44 (49.4 percent) isolates respectively, across the rivers studied. We conclude that aquatic resources of the study community are important reservoirs of pathogenic Acinetobacter species and antibiotic resistance determinants. The occurrence of clinically-important Acinetobacter species suggests possible contamination of these selected rivers which are consumed by humans and livestock, as well as being used for irrigation system, and this constitutes a risk to public health. It also shows that A. baumannii and A. nosocomialis can thrive in the aquatic environment. This study suggests that direct utilization of water from these sources for domestic and other purposes without any form of pre-treatment should be avoided. It is, therefore, necessary for regulatory authorities to monitor the release of domestic and industrial wastewater into these water bodies in order to prevent outbreaks of epidemics. , Thesis (PhD) (Microbiology) -- University of Fort Hare, 2019
- Full Text:
- Date Issued: 2019-09
- Authors: Adewoyin, Mary Ayobami https://orcid.org/0000-0001-7489-7402
- Date: 2019-09
- Subjects: Acinetobacter infections http://id.loc.gov/authorities/subjects/sh95004928 , Acinetobacter http://id.loc.gov/authorities/subjects/sh91001451 , Nosocomial infections http://id.loc.gov/authorities/subjects/sh85092770
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/19836 , vital:43257
- Description: This study evaluates the occurrence of medically relevant Acinetobacter species in three rivers, namely; Keiskamma, Tyhume and Great Fish in the Eastern Cape Province, South Africa in one year sampling regime (April 2017 - March 2018). The physicochemical parameters (pH, temperature (TEM), electrical conductivity (EC), total dissolved solids (TDS), salinity (SAL), total suspended solids (TSS), turbidity (TBS), dissolved oxygen (DO) and biological oxygen demand (BOD)) of the water bodies were measured. The presumptive Acinetobacter species recovered from the freshwater resources were recorded and further confirmed using molecular techniques. Similarly, confirmed isolates were subjected to speciation using species-specific primer sets for A. baumannii and A. nosocomialis. Also, virulence genes namely; afa/draBC, epsA, fimH, OmpA, PAI, sfa/focDE, and traT in the two Acinetobacter species were also determined using molecular method. In addition, the antibiogram characteristics of A. baumannii and A. nosocomialis isolated from the water samples were determined using standard methods. The antibiotic susceptibility test was performed using a panel of 12 antibiotics belonging to the aminoglycosides (amikacin, AK and gentamicin, GM), β-lactam/β-lactamase-inhibitor combinations (piperacillin-tazobactam, PTZ), cephems (ceftazidime, CAZ, cefotaxime, CTX, and cefepime, CPM), carbapenems (imipenem, IMI and meropenem, MEM), fluoroquinolones (ciprofloxacin, CIP), folate pathway inhibitors (Trimethoprim/sulfamethoxazole, TS), lipopeptides (Polymyxin B, PB) and tetracyclines (tetracycline, TET). Similarly, antibiotic resistance genes (ARGs) present in the Acinetobacter isolates were investigated including aminoglycoside resistance genes (aacC2, aphA1 and aphA2), β-lactamases resistance genes (blaTEM, blaSHV, blaOXA-1-like, blaCTX-M(GROUP 1), blaCTX-M(GROUP 2), blaCTX-M(GROUP 9), blaVEB, blaGES, blaPER, blaCTX-M-8/-25, blaOXA-48-like, blaVIM, blaIMP and blaKPC), fluoroquinolones resistance genes (qnrA, qnrB, qnrC, qnrD and qnrS), sulfonamide resistance genes (sul1 and sul2), and tetracycline resistance genes (tetA, tetB, tetC, tetM, tetL and tetO). The pH, EC, TDS, SAL, TEMP, TSS, TBS, DO, and BOD for Tyhume River ranged as follows: 7.2-7.7, 125-141 μS/cm, 62-71mg/L, 0.06- 0.07 PSU, 11.3-20.2oC, 30.0-89.6 mg/L, 35.0-96.0 NTU, 8.2-9.8 mg/L, 2.0-4.2 mg/L, while for Great Fish River, the parameters were 8.0-8.2, 274-369 μS/cm, 137-184mg/L, 0.13-0.18PSU, 12.7-22.3oC, 44.3-99.4 mg/L, 48.0-214.0 NTU, 7.8-9.9 mg/L, 3.1- 4.9 mg/L, and at Keiskamma River they were 7.5-7.9, 153.2-285.0 μS/cm, 86-143 mg/L, 0.07-0.14 PSU, 11.0-21.4oC, 27.0- 55.6 mg/L, 31-61 NTU, 8.3-9.8 mg/L, 3.0-6.0 mg/L. A total of 1107 presumptive Acinetobacter spp. were recovered from the rivers sampled of which 428, 370 and 309 isolates were recovered from Tyhume, Great Fish and Keiskamma rivers respectively. However, only 844 was confirmed positive for the genus Acinetobacter and are recovered in the proportions 285 (77 percent), 219 (70.9 percent) and 340 (79 percent) from Great Fish, Keiskemma and Tyhume rivers respectively. Our finding revealed that 410 (48.58 percent) and 23 (2.7 percent) of the isolates were confirmed to be A. baumannii and A. nosocomalis respectively. Also, 308 (75.12 percent percent) A. baumannii and 3 (13.04 percent) A. nosocomialis isolates exhibited one or more virulence genes out of the seven tested, whereas 102 (24.88 percent) and 20 (86.95 percent) of the A. baumannii and A. nosocomialis isolates did not harbour any virulence gene. Additionally, OmpA was the most prevalent (p<0.05) virulence gene found in A. baumannii with 69 (45.10 percent), 52 (50.98 percent) and 77 (49.68 percent) isolates from Great Fish, Keiskamma and Tyhume rivers respectively. The rates of susceptibilities of A. baumannii and A. nosocomialis to the antibiotics followed the order; Piperacillin-tazobactam (72.8 percent ; 73.9 percent), Ceftazidime (70.5 percent ; 91.3 percent), Cefotaxime (16.8 percent ; 17.4 percent), Cefepime (88.5 percent ; 95.7 percent), Imipenem (95.9 percent ; 100 percent ), Meropenem (92.7 percent ; 91.3 percent), Amikacin (97.6 percent ; 91.3 percent), Gentamicin (89.8 percent ; 87 percent), Polymyxin B (84.4 percent ; 91.3 percent), Tetracycline (74.7 percent ; 78.3 percent), Ciprofloxacin (75.9 percent ; 78.3 percent) and Trimethoprim/sulfamethoxazole (74.0 percent ; 73.9 percent) respectively. Both A. baumannii and A. nosocomialis were highly susceptible to all the antimicrobials tested except cefotaxime where 64 percent and 78 percent intermediate responses were observed in the species. At least 10 isolates of A. baumannii were resistant against each of the antibiotics used. The modal multiple antibiotics resistance phenotypes (MARPs) for Acinetobacter spp. was MARP 3 (29.87 percent) and the least was MARP 10 and 11 (2.6 percent each). The antimicrobial resistance index (ARI) was higher at two sampling sites KE2 (0.33) and TY1 (0.22). Similarly, MARI showed that sampling sites KE2 was a hotspot for multidrug-resistant Acinetobacter spp. Of the five classes of ARGs studied, there was a widespread of β-lactamases (blaTEM) in the two Acinetobacter species, followed by sul2, which were detected in 67 (63.2 percent) and 44 (49.4 percent) isolates respectively, across the rivers studied. We conclude that aquatic resources of the study community are important reservoirs of pathogenic Acinetobacter species and antibiotic resistance determinants. The occurrence of clinically-important Acinetobacter species suggests possible contamination of these selected rivers which are consumed by humans and livestock, as well as being used for irrigation system, and this constitutes a risk to public health. It also shows that A. baumannii and A. nosocomialis can thrive in the aquatic environment. This study suggests that direct utilization of water from these sources for domestic and other purposes without any form of pre-treatment should be avoided. It is, therefore, necessary for regulatory authorities to monitor the release of domestic and industrial wastewater into these water bodies in order to prevent outbreaks of epidemics. , Thesis (PhD) (Microbiology) -- University of Fort Hare, 2019
- Full Text:
- Date Issued: 2019-09
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